Skip to main content
PMC home page
Thorax logoLink to Thorax
. 2001 May;56(5):388–393. doi: 10.1136/thorax.56.5.388

Pulmonary function in adolescent idiopathic scoliosis: a 25 year follow up after surgery or start of brace treatment

K Pehrsson 1, A Danielsson 1, A Nachemson 1
PMCID: PMC1746049  PMID: 11312408

Abstract

BACKGROUND—Pulmonary function in patients with adolescent idiopathic scoliosis many years after posterior spinal surgery or brace treatment has not been documented.
METHODS—A consecutive group of patients treated by posterior fusion or a brace at least 20 years previously was investigated. 90% attended a clinical follow up. Lung volumes were determined before treatment in 251 patients, 1.4 years after surgery in 141 patients, and 25 years after surgery or start of brace treatment in 110patients. Vital capacity (VC) was calculated as percentage predicted according to height and age and the results were corrected for loss of height due to scoliosis. Scoliosis angles were measured and smoking habits were recorded. An age and sex matched control group was also examined with the same questionnaire and pulmonary function tests.
RESULTS—VC increased from 67% predicted immediately before surgery to 73% (p<0.001) after surgery and to 84% (p<0.001) at the present follow up, mean change 10.8% (95% CI 9.5 to 12.1). In the brace treated patients VC increased from 77% predicted before treatment to 89% (p<0.001) 25 years after start of treatment, mean change 12.3% (95% CI 10.5 to 14.1). The mean Cobb angle at the present follow up study was 40° in both surgically and brace treated patients. The present results of lung volumes did not correlate with pretreatment or post-treatment Cobb angles or smoking habits.
CONCLUSIONS—Patients treated by posterior fusion or a brace gradually increase their pulmonary function up to 25 years after treatment. Smoking and curve size are not risk factors for reduced pulmonary function.



Full Text

The Full Text of this article is available as a PDF (144.3 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BERGLUND E., BIRATH G., BJURE J., GRIMBY G., KJELLMER I., SANDQVIST L., SODERHOLM B. Spirometric studies in normal subjects. I. Forced expirograms in subjects between 7 and 70 years of age. Acta Med Scand. 1963 Feb;173:185–192. [PubMed] [Google Scholar]
  2. Bergofsky E. H. Respiratory failure in disorders of the thoracic cage. Am Rev Respir Dis. 1979 Apr;119(4):643–669. doi: 10.1164/arrd.1979.119.4.643. [DOI] [PubMed] [Google Scholar]
  3. Cochran T., Irstam L., Nachemson A. Long-term anatomic and functional changes in patients with adolescent idiopathic scoliosis treated by Harrington rod fusion. Spine (Phila Pa 1976) 1983 Sep;8(6):576–584. doi: 10.1097/00007632-198309000-00003. [DOI] [PubMed] [Google Scholar]
  4. Cochran T., Nachemson A. Long-term anatomic and functional changes in patients with adolescent idiopathic scoliosis treated with the Milwaukee brace. Spine (Phila Pa 1976) 1985 Mar;10(2):127–133. doi: 10.1097/00007632-198503000-00003. [DOI] [PubMed] [Google Scholar]
  5. Gagnon S., Jodoin A., Martin R. Pulmonary function test study and after spinal fusion in young idiopathic scoliosis. Spine (Phila Pa 1976) 1989 May;14(5):486–490. doi: 10.1097/00007632-198905000-00002. [DOI] [PubMed] [Google Scholar]
  6. Goldstein L. A., Waugh T. R. Classification and terminology of scoliosis. Clin Orthop Relat Res. 1973 Jun;(93):10–22. doi: 10.1097/00003086-197306000-00003. [DOI] [PubMed] [Google Scholar]
  7. HARRINGTON P. R. Treatment of scoliosis. Correction and internal fixation by spine instrumentation. J Bone Joint Surg Am. 1962 Jun;44-A:591–610. [PubMed] [Google Scholar]
  8. Katsaris G., Loukos A., Valavanis J., Vassiliou M., Behrakis P. K. The immediate effect of a Boston brace on lung volumes and pulmonary compliance in mild adolescent idiopathic scoliosis. Eur Spine J. 1999;8(1):2–7. doi: 10.1007/s005860050119. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Kinnear W. J., Johnston I. D. Does Harrington instrumentation improve pulmonary function in adolescents with idiopathic scoliosis? A meta-analysis. Spine (Phila Pa 1976) 1993 Sep 1;18(11):1556–1559. [PubMed] [Google Scholar]
  10. Korovessis P., Filos K. S., Georgopoulos D. Long-term alterations of respiratory function in adolescents wearing a brace for idiopathic scoliosis. Spine (Phila Pa 1976) 1996 Sep 1;21(17):1979–1984. doi: 10.1097/00007632-199609010-00008. [DOI] [PubMed] [Google Scholar]
  11. Kumano K., Tsuyama N. Pulmonary function before and after surgical correction of scoliosis. J Bone Joint Surg Am. 1982 Feb;64(2):242–248. [PubMed] [Google Scholar]
  12. Lindh M., Bjure J. Lung volumes in scoliosis before and after correction by the Harrington instrumentation method. Acta Orthop Scand. 1975 Dec;46(6):934–948. doi: 10.3109/17453677508989282. [DOI] [PubMed] [Google Scholar]
  13. Nachemson A. A long term follow-up study of non-treated scoliosis. Acta Orthop Scand. 1968;39(4):466–476. doi: 10.3109/17453676808989664. [DOI] [PubMed] [Google Scholar]
  14. Pehrsson K., Bake B., Larsson S., Nachemson A. Lung function in adult idiopathic scoliosis: a 20 year follow up. Thorax. 1991 Jul;46(7):474–478. doi: 10.1136/thx.46.7.474. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Pehrsson K., Larsson S., Oden A., Nachemson A. Long-term follow-up of patients with untreated scoliosis. A study of mortality, causes of death, and symptoms. Spine (Phila Pa 1976) 1992 Sep;17(9):1091–1096. doi: 10.1097/00007632-199209000-00014. [DOI] [PubMed] [Google Scholar]
  16. RISSER J. C. The Iliac apophysis; an invaluable sign in the management of scoliosis. Clin Orthop. 1958;11:111–119. [PubMed] [Google Scholar]
  17. Vedantam R., Lenke L. G., Bridwell K. H., Haas J., Linville D. A. A prospective evaluation of pulmonary function in patients with adolescent idiopathic scoliosis relative to the surgical approach used for spinal arthrodesis. Spine (Phila Pa 1976) 2000 Jan;25(1):82–90. doi: 10.1097/00007632-200001010-00015. [DOI] [PubMed] [Google Scholar]
  18. Wong C. A., Cole A. A., Watson L., Webb J. K., Johnston I. D., Kinnear W. J. Pulmonary function before and after anterior spinal surgery in adult idiopathic scoliosis. Thorax. 1996 May;51(5):534–536. doi: 10.1136/thx.51.5.534. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES